摘要
目的探讨慢性心力衰竭(CHF)患者心脏同步化治疗(CRT)近期及远期效果与肺动脉收缩压(PASP)的关系。方法选择行CRT的42例CHF患者,根据术前PASP水平分为高PASP组(PASP≥45 mm Hg,1 mm Hg=0.133 k Pa)(n=15)和低PASP组(PASP<45 mm Hg)(n=27)。分别对2组患者CRT植入术前、术后6个月、1、2 a的心功能分级评估情况、PASP、左心室舒张末期内径(LVEDD)、QRS波、左心室射血分数(LVEF)、左心室短轴缩短率(FS)及血浆脑钠肽(BNP)水平进行观察比较。并对2组患者术后6个月的CRT反应率进行比较。结果 2组患者术前PASP水平比较差异无统计学意义(P>0.05);2组患者术后6个月、1、2 a的PASP水平均显著低于术前(P<0.05),2组患者术后1、2 a的PASP水平均显著低于术后6个月(P<0.05),术后2 a与术后1 a的PASP水平比较差异无统计学意义(P>0.05)。低PASP组患者术后6个月、1、2 a的PASP水平均显著低于相同时间点高PASP组(P<0.05)。2组患者术后6个月、1、2 a的心功能分级、LVEDD、QRS波、LVEF、FS及BNP水平均显著优于术前(P<0.05);术后1、2 a上述指标均优于术后6个月水平(P<0.05);术后1 a与术后2 a上述各指标比较差异均无统计学意义(P>0.05)。手术前2组患者各指标比较差异均无统计学意义(P>0.05);术后6个月、1、2 a,低PASP组患者的心功能分级、LVEF、BNP水平均显著优于低PASP组(P<0.05);LVEDD、QRS波及FS水平2组患者各时间点比较差异均无统计学意义(P>0.05)。高PASP组和低PASP组患者术后6个月CRT反应率分别为46.7%(7/15)和77.8%(21/27),低PASP组患者术后6个月的CRT反应率高于高PASP组(P<0.05)。结论 CRT植入术用于低PASP患者的近期和远期的心功能改善效果明显优于高PASP患者,且CRT反应率也显著高于高PASP患者。
Objective To explore the relationship between recent and long-term effect of cardiac synchronization therapy（ CRT） and pulmonary artery systolic pressure（ PASP） in patients with chronic heart failure（ CHF）. Methods Forty two patients with CHF who received CRT were divided into high PASP group（ PASP≥45 mmHg,1 mmHg = 0. 133 kPa）（ n = 15）and low PASP group（ PASP 〈45 mmHg）（ n = 27）. Cardiac function classification assessment,PASP,left ventricular diastolic diameter（ LVEDD）,QRS wave,left ventricular ejection fraction（ LVEF）,fraction shortening（ FS） and brain natriuretic peptide（ BNP） of patients in both groups before CRT implantation,6 months,1 year and 2 years postoperative were observed and compared. CRT response rate of the patients in the two groups were compared. Results There were no statistic difference of PASP levels of patients between the two groups before operation（ P〉0. 05）. PASP levels of patients in the both groups at 6months,1 year and 2 years postoperative were significantly lower than those of preoperative（ P〈0. 05）; PASP levels of patients in the both groups at 1 year and 2 years postoperative were significantly lower than those at 6 months（ P〈0. 05）; there were no statistic difference of PASP levels of patients in the both groups between 1 year and 2 years postoperative（ P〉0. 05）. PASP levels in low PASP group at 6 months,1 year and 2 years postoperative were significantly lower than those in high PASP group（ P〈0. 05）. The cardiac function classification assessment,LVEDD,QRS wave,LVEF,FS and BNP of patients in both groups at 6 months,1 year and 2 years postoperative were better than those at preoperative（ P〈0. 05）; the above indexes of patients in the both groups at 1 and 2 years postoperative were better than those at 6 months postoperative（ P〉0. 05）; there were no statistic difference of above indexes of patients in the both groups between 1 year and 2 years postoperative（ P〈0. 05）. There was no statistic difference of above indexes of patients between the two groups before operation（ P〉0. 05）; the cardiac function classification assessment,LVEF and BNP levels of patients in low PASP group at 6 months,1 year and 2 years postoperative were significantly better than those in high PASP group（ P〈0. 05）; there were no statistic difference of LVEDD,QRS wave and FS levels of patients between the two groups at each time piont postoperative（ P〉0. 05）. CRT response rate in low PASP group（ 77. 8%,21 /27） was significantly higher than that in high PASP group（ 46. 7%,7 /15） at 6 months postoperative（ P〈0. 05）. Conclusion The recent and long-term effect of CRT in low PASP patients is better than that in high PASP patients,and the CRT response rate in low PASP patients is higher than that in high PASP patients.
出处
《新乡医学院学报》
CAS
2016年第10期887-890,共4页
Journal of Xinxiang Medical University
关键词
心脏同步化治疗
肺动脉收缩压
心功能分级
慢性心力衰竭
cardiac resynchronization therapy
pulmonary artery systolic pressure
cardiac function classification assessment
chronic heart failure
